Modified Glasgow Prognostic Score (mGPS) for Cancer Outcomes
Why Use
Multiple studies suggest significantly worse outcome in multiple types of cancer, including “increased weight loss, poor performance status, increased comorbidity, increased pro-inflammatory and angiogenic cytokines and complications on treatment.” ( McMillan DC 2013 )
When to Use
Patients with known cancer.
Formula
Pearls / Pitfalls
The Modified Glasgow Prognostic Score (mGPS) has been evaluated across numerous different cancer cohorts and suggests incrementally worsening prognosis with increasing score. Depending upon patient selection, stage, cancer and other factors the resulting survival numbers vary widely. The modified GPS uses the same parameters as the original GPS (CRP and albumin), but weighs the inflammatory component more heavily; i.e., patients with low albumin are still assigned a score of 0 as long as CRP is not elevated. This modification was shown to have better correlation with survival (in colon and rectal cancer from the original paper, and in other cancers from the validation papers).
Management
We are unaware of validated management algorithms using the mGPS.
Critical Actions
The modified GPS does not assign a point for low albumin as a singular finding, which is different from the original GPS . The c-reactive protein value must be elevated for points to be assigned.
Advice
The Modified Glasgow Prognosis Score helps stratify prognosis groups and may be a worthy addition to multifactorial evaluations. As a stand-alone in individual cases it is unclear at this point how accurate it is likely to be.
More Information
The modified GPS uses the same parameters as the original GPS (CRP and albumin), but weighs the inflammatory component more heavily; i.e., patients with low albumin are still assigned a score of 0 even if CRP is elevated. This modification was shown to have better correlation with survival (in colon and rectal cancer from the original paper, and in other cancers from the validation papers). The mGPS has been shown to be accurate in different types of cancer, including renal, lung, gastric cancers, as well as in primary care. The predictive values are listed below for each type of cancer. Type of cancer mGPS Median Survival Gastric 0 5 year Overall Survival: 74.6% 1 5 year Overall Survival: 61.4% 2 5 year Overall Survival: 34.6% Renal 0 1 year RFS: 90.9% 1 1 year RFS: 61.1% 2 1 year RFS: 10.1% Lung (Small Cell) 0 3 Month Survival: 99% 2 3 Month Survival: 71%